| NPI | 1861539694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN THOMPSON Administrator 314-569-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO R9531) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2004012770) |
| 207WX0107X Ophthalmology, Retina Specialist | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2024-01-24 |